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Improving Shared Decision Making For Asian American Pacific Islander Sexual and Gender Minorities
- Source :
- Medical care, vol 57, iss 12, Med Care
- Publication Year :
- 2019
- Publisher :
- eScholarship, University of California, 2019.
-
Abstract
- BackgroundAsian American Pacific Islander (AAPI) sexual and gender minorities (SGM) face unique challenges in mental health and accessing high-quality health care.ObjectiveThe objective of this study was to identify barriers and facilitators for shared decision making (SDM) between AAPI SGM and providers, especially surrounding mental health.Research designInterviews, focus groups, and surveys.SubjectsAAPI SGM interviewees in Chicago (n=20) and San Francisco (n=20). Two focus groups (n=10) in San Francisco.MeasuresParticipants were asked open-ended questions about their health care experiences and how their identities impacted these encounters. Follow-up probes explored SDM and mental health. Participants were also surveyed about attitudes towards SGM disclosure and preferences about providers. Transcripts were analyzed for themes and a conceptual model was developed.ResultsOur conceptual model elucidates the patient, provider, and encounter-centered factors that feed into SDM for AAPI SGM. Some participants shared the stigma of SGM identities and mental health in their AAPI families. Their AAPI and SGM identities were intertwined in affecting mental health. Some providers inappropriately controlled the visibility of the patient's identities, ignoring or overemphasizing them. Participants varied on whether they preferred a provider of the same race, and how prominently their AAPI and/or SGM identities affected SDM.ConclusionsProviders should understand identity-specific challenges for AAPI SGM to engage in SDM. Providers should self-educate about AAPI and SGM history and intracommunity heterogeneity before the encounter, create a safe environment conducive to patient disclosure of SGM identity, and ask questions about patient priorities for the visit, pronouns, and mental health.
- Subjects :
- Gerontology
Male
Native Hawaiian or Other Pacific Islander
Social stigma
Asian American and Pacific Islander
Social Stigma
Decision Making
shared decision making
MEDLINE
Face (sociological concept)
Article
Interviews as Topic
03 medical and health sciences
Asian american pacific islander
Sexual and Gender Minorities
0302 clinical medicine
7.1 Individual care needs
gay
Clinical Research
Humans
030212 general & internal medicine
bisexual
and queer
Asian
030503 health policy & services
Public Health, Environmental and Occupational Health
lesbian
Health Services
Mental health
transgender
Shared
Sexual minority
Mental Health
Good Health and Well Being
Applied Economics
Public Health and Health Services
Health Policy & Services
Female
Management of diseases and conditions
Patient Participation
0305 other medical science
Psychology
Decision Making, Shared
Subjects
Details
- Database :
- OpenAIRE
- Journal :
- Medical care, vol 57, iss 12, Med Care
- Accession number :
- edsair.doi.dedup.....f54829a5e978af705593297573b12075